Psychiatric Emergency Services Deidre Woodford BNRN (C) PMHN Patient Care Facilitator Psychiatric Emergency Services Office: 709-777-3083 Email: deidre.woodford@easternhealth.ca

Objectives To identify what is a Mental Health Crisis To identify who is affected by a Mental Health Crisis To identify what Psychiatric Emergency Services Exits To discuss current Facts and Statistics To review algorithm for Psychiatric Emergency Services To review Staff Training and Education

What is Mental Health Crisis? “The onset of an emotional disturbance or situation distress (which may be cumulative) involving a sudden breakdown of an individual’s ability to cope” It can include feelings of being overwhelmed, stressed, frustrated Crisis can happen at any time; for anyone. We all experience crisis!

Are you in need of Mental Health Emergency Services? Our mental health can be affected by: Relationships with family or friends Addiction Issues Financial Difficulties School or work stress Grief or Loss Abuse or Traumatic Events Illness

What are Mental Health Emergency Services? Waterford Hospital Psychiatric Assessment Unit (PAU) Waterford Hospital Short Stay Unit/West 2 A (Inpatient Unit) Health Sciences Hospital Emergency Mental Health Nurse Carbonear General Hospital Emergency Mental Health Nurse Mental Health Crisis Center (MHCL) Gambling Addiction Helpline Mobile Crisis Response Team (MCRT)

Psychiatric Assessment Unit (PAU) Mental Health Emergency Room (Not Medical Emergency Room); operational 24 hours a day year round All clients are seen by Psychiatric Nurse, Physician and or Psychiatric Resident/Psychiatrist No referral needed Is the only Psychiatric Emergency Room in Newfoundland & Labrador

Short Stay Unit/ West 2 A Inpatient unit for brief crisis stabilization 7 private rooms 3 “holding beds” used for further observation (maximum 23 hours) Average length of stay for SSU 3.5 days Team includes: RN’s, Nurse Practitioner, Social Worker, and Psychiatrist. (Multidisciplinary) Intensive intervention; each client sees each team member, every weekday.

Health Sciences & Janeway Emergency Room Services Registered Nurse for Health Sciences & Janeway Emergency Room 0730-1930 One Registered Nurse Consulted between HSC and Janeway Emergency Rooms as needed Registered Nurse does assessments and referrals No Referral Needed Registered Nurse may consult to Psychiatry at the Waterford Hospital if needed

Carbonear General Hospital Emergency Room Registered Nurse for Carbonear General Hospital Emergency Department 0800-1600 One Registered Nurse Consulted between Carbonear ER and Carbonear General Inpatient Units Registered Nurse does assessments and referrals No Referral Needed Registered Nurse may consult to Psychiatrist as needed

Mental Health Crisis Phone Line 737-4668 or 1-888-737-4668 24 hours a day Province wide Voluntary Confidential No referral required Crisis Center has NO CALLER ID

Gambling Addiction Helpline 24 hours a day Province wide Voluntary Confidential No referral required NO CALLER ID

Mobile Crisis Response Team MCR Team involves professional Crisis Interveners trained to assist people deal with crisis, visiting people in their home, work or community. The team consists of Psychiatric Registered Nurses, Social Workers, Licensed Practical Nurses and RNC officers. All Staff are Crisis Intervenors. The team coordinates with other professionals as required (physicians, police, case managers etc.)

2017 Psychiatric Emergency Services Facts and Statistics 2017 Psychiatric Emergency Services 3000 + visits to PAU (1000 + at HSC) 800 admissions to SSU 12 000 calls to the MHCC Last year there were 1900 work hours spent by police officers in PAU with clients detained under MHCTA

Psychiatric Emergency Services Algorithm Register Triage Assessed By RN Assessed By Physician Discharged Admitted Consulted to Psychiatry

Psychiatric Emergency Services Algorithm MHCTA

HSC and Janeway Emergency Services Algorithm

Staff are experts in relevant legislation and reporting requirements: Mental Health Care & Treatment Act Child Youth & Family Services Act Neglected Adults Act Duty To Warn

In addition to their educational background, staff have additional training in: Therapeutic Crisis Intervention Violence Threat Assessment Suicide Assessment Responding to Traumatic Events Conflict Resolution De-escalating Violence Critical Incident Stress Management Mental Health Status Exam Education on symptoms of psychiatric illness and psychiatric medications.

Questions????